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Obesity Linked to Problems in Spine Surgery
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Posted on: 04/12/2007
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Are obese patients at increased risk for complications during and after spine surgery? In this study, 86 cases of elective thoracic and lumbar spine fusions in obese patients were examined for such problems.
The same surgeon operated on all the patients. All complications (small or large) were included. Examples include wound infection, blood clots, heart attacks or strokes, and pneumonia. Nerve pain or nerve palsy was also included.
Anything that delayed recovery or added time to the hospital stay was also counted as a complication. All problems that occurred in the first 30 days of surgery were included.
The researchers looked to see which factors might be important. Age, sex, height, weight, and body mass index (BMI) were assessed. The presence or absence of diabetes and high blood pressure were also considered. And the number of spinal segments fused (one or more) and type of fusion performed were factored in.
The results showed an overall complication rate of about 37 per cent. At least one in every three patients had a problem. Almost half the patients had high blood pressure but this did not seem to increase their risk of problems. Problems were more likely to occur in older patients.
The higher the BMI, the greater the risk of problems. Very obese patients were also at risk for nerve palsies. Staying in one position too long with the pressure of body weight on the nerve caused the problem.
The authors offer two conclusions from this study. First, obesity should be considered a risk factor when planning spine surgery. And second, care should be taken with very obese patients to limit the amount of time in one position. Support and padding for the arms and legs may help. These steps may help prevent position-related nerve palsies.
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References:
Nimesh Patel, MD, et al. Obesity and Spine Surgery: Relation to Perioperative Complications. In Journal of Neurosurgery:Spine. April 2007. Vol. 6. No. 4. Pp. 291-297.
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